Annals of hepatology最新文献

{"title":"Latin American association for the study of the liver (ALEH) guidance on postoperative care after liver transplantation","authors":"Liana Codes ,&nbsp;Rodrigo Zapata ,&nbsp;Manuel Mendizabal ,&nbsp;Alfeu de Medeiros Fleck Junior ,&nbsp;Juan Carlos Restrepo ,&nbsp;Leonardo de Lucca Schiavon ,&nbsp;Luiz Marcelo Sá Malbouisson ,&nbsp;Wellington Andraus ,&nbsp;Adrian Gadano ,&nbsp;P. Martin Padilla-Machaca ,&nbsp;Alejandra Villamil ,&nbsp;Raquel Silveira Bello Stucchi ,&nbsp;Graciela Elia Castro-Narro ,&nbsp;Josefina Pages ,&nbsp;Debora Raquel Benedita Terrabuio ,&nbsp;Alvaro Urzúa ,&nbsp;Mário Guimarães Pessoa ,&nbsp;Victoria Mainardi ,&nbsp;Rodolpho Pedro ,&nbsp;Oscar Imventarza ,&nbsp;Pablo Coste Murillo","doi":"10.1016/j.aohep.2025.101899","DOIUrl":"10.1016/j.aohep.2025.101899","url":null,"abstract":"<div><div>Liver transplantation (LT) is a well-established therapy for patients with decompensated cirrhosis and early-stage hepatocellular carcinoma. Liver transplantation activity varies sharply across Latin American (LATAM) countries due to differences in resources, expertise, and funding and local attitudes toward organ donation and transplantation. This current guidance of postoperative care after LT is the first position paper of the Latin American Association for the Study of the Liver (ALEH) Special Interest Group (SIG), drawing evidence-based recommendations regarding immediate and long-term postoperative care of LT recipients, taking into consideration their applicability in Latin America.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 2","pages":"Article 101899"},"PeriodicalIF":3.7,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143584396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global burden and future trends of metabolic dysfunction-associated Steatotic liver disease: 1990-2021 to 2045","authors":"Chengxia Kan ,&nbsp;Kexin Zhang ,&nbsp;Yuqun Wang ,&nbsp;Xiaofei Zhang ,&nbsp;Chang Liu ,&nbsp;Yanhui Ma ,&nbsp;Ningning Hou ,&nbsp;Na Huang ,&nbsp;Fang Han ,&nbsp;Xiaodong Sun","doi":"10.1016/j.aohep.2025.101898","DOIUrl":"10.1016/j.aohep.2025.101898","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>Metabolic dysfunction-associated steatotic liver disease (MASLD), formerly non-alcoholic fatty liver disease, is a growing global health challenge. This study examines the global burden of MASLD from 1990 to 2021 and projects data for 2045.</div></div><div><h3>Materials and Methods</h3><div>Using data from the Global Burden of Disease (GBD) Study 2021, the study analyzed MASLD across 204 countries from 1990 to 2021, focusing on prevalence, incidence, deaths, and disability-adjusted life years (DALYs). Linear and Joinpoint regression assessed trends, an age-period-cohort model evaluated health outcomes, and a Bayesian model forecasted future cases.</div></div><div><h3>Results</h3><div>In 2021, approximately 1.27 billion people globally had MASLD, with a higher prevalence in males (51.41 %). There were 48.35 million new cases, primarily in males (52.24 %). The age-standardized prevalence rate (ASPR) increased from 12,085.09 in 1990 to 15,018.07 per 100,000 in 2021 (AAPC 0.71). The age-standardized incidence rate (ASIR) rose from 475.54 to 593.28 per 100,000 (AAPC 0.71). MASLD caused 138,328 deaths, with females experiencing higher mortality (52.18 %). East Asia, South Asia, and North Africa/Middle East had the highest prevalence and incidence rates, while Western Europe showed the fastest growth. By 2045, ASIR is projected to reach 928.10 per 100,000, resulting in 667.58 million new cases, predominantly affecting males.</div></div><div><h3>Conclusions</h3><div>MASLD poses a significant burden with notable gender and regional disparities. The projected increase by 2045 underscores the need for urgent public health interventions and targeted strategies to mitigate this growing epidemic.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 2","pages":"Article 101898"},"PeriodicalIF":3.7,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143584394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical spectrum and long-term outcomes of non-cirrhotic portal venous system thrombosis in Hispanic population.","authors":"Fernando Gil López, Fausto Rios Olais, Roberta Demichelis, Angel Vargas Ruiz, Analy Mora Cañas, Lydia A Mercado, Denise M Harnois, Juan Rangel-Patiño","doi":"10.1016/j.aohep.2025.101786","DOIUrl":"10.1016/j.aohep.2025.101786","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>Portal venous system thrombosis (PVT) outside the setting of cirrhosis is uncommon with limited information available about the etiological and clinical characteristics across varied racial and ethnic groups.</p><p><strong>Materials and methods: </strong>This retrospective cohort study examines the long-term outcomes of non-cirrhotic, Hispanic adults diagnosed with PVT at a single center in Mexico City between January 2000 and August 2023. Patients with conditions predisposing to PVT were excluded.</p><p><strong>Results: </strong>We included 100 Hispanic adults diagnosed with non-cirrhotic PVT. Thrombophilia was identified in 49 %, with antiphospholipid syndrome (APS) being the most prevalent thrombophilia (23 %), followed by JAK2 mutation (18 %). Chronic PVT, observed in 70 % of cases, predominantly affected the portal vein (50 %), followed by porto-mesenteric (41 %) and porto-splenic (9 %) territories. At diagnosis, 55 % had esophageal varices. Anticoagulant therapy was administered to over half of the patients for >12 months. Over a median follow-up of 55 months, the 5-year risk of re-thrombosis was 24 %, and the 5-year risk of variceal bleeding (VB) was 45 %. The 4-year overall survival (OS) was 97 %. Comparative analysis between thrombophilia-associated and idiopathic PVT did not reveal significant differences in VB, re-thrombosis, and OS.</p><p><strong>Conclusions: </strong>This study underscores the unique clinical profile of Hispanic patients with non-cirrhotic PVT, highlighting a high prevalence of APS and substantial risks of VB. These findings contribute to a better understanding of PVT in Hispanics and emphasize the importance of tailored management strategies. Our results' generalizability may be limited by the thrombophilia testing approach, the excluded populations, and its retrospective, single center nature.</p>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":" ","pages":"101786"},"PeriodicalIF":3.7,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143490545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A putative hepatitis B virus sequence motif associated with hepatocellular carcinoma in South African adults","authors":"Tongai G. Maponga ,&nbsp;Anna L. McNaughton ,&nbsp;Cori Campbell ,&nbsp;Mariateresa de Cesare ,&nbsp;Jolynne Mokaya ,&nbsp;Sheila F. Lumley ,&nbsp;David Bonsall ,&nbsp;Camilla LC Ip ,&nbsp;Haiting Chai ,&nbsp;Christo Van Rensburg ,&nbsp;Richard H. Glashoff ,&nbsp;Elizabeth Waddilove ,&nbsp;Wolfgang Preiser ,&nbsp;Jason T. Blackard ,&nbsp;M. Azim Ansari ,&nbsp;Anna Kramvis ,&nbsp;Monique I. Andersson ,&nbsp;Philippa C Matthews","doi":"10.1016/j.aohep.2024.101763","DOIUrl":"10.1016/j.aohep.2024.101763","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>Chronic hepatitis B virus (HBV) infection is a major risk factor for hepatocellular carcinoma (HCC). In African populations, HCC frequently presents at an advanced stage with poor outcomes. We applied whole genome sequencing (WGS) to compare HBV genomes in individuals with and without HCC.</div></div><div><h3>Materials and Methods</h3><div>We identified adults with HBV infection, with and without complicating HCC, in Cape Town, South Africa. We generated HBV WGS using pan-genotypic probe-based enrichment followed by Illumina sequencing.</div></div><div><h3>Results</h3><div>Compared to the non-HCC group, HCC patients were more likely to be male (<em>p</em> &lt; 0.0001), older (<em>p</em> = 0.01), HIV-negative (<em>p</em> = 0.006), and have higher HBV viral loads (<em>p</em> &lt; 0.0001). Among 19 HCC and 12 non-HCC patients for whom WGS was obtained, genotype A dominated (74 %), of which 96 % were subgenotype A1. PreS2 deletions (Δ38–55) were enriched in HBV sequences from HCC patients (<em>n</em> = 7). The sequence motif most strongly associated with HCC comprised either a deletion or polymorphism at site T53 in PreS2 – collectively coined ‘non-T53’ – together with a basal core promoter (BCP) mutation G1764A (AUROC = 0.79).</div></div><div><h3>Conclusions</h3><div>In this setting, HBV sequence polymorphisms and deletions are associated with HCC, and ‘non-T53 + G1764A’ represents a putative signature motif for HCC. Additional investigations are needed to disaggregate the impact of other demographic, clinical, and environmental influences, to ascertain the extent to which viral polymorphisms contribute to oncogenesis, and to determine whether HBV sequence is a useful biomarker for HCC risk stratification.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 2","pages":"Article 101763"},"PeriodicalIF":3.7,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effects of HAPA theory-based case management in patients with metabolic dysfunction-associated steatotic liver disease","authors":"Jia Mei,&nbsp;Yuncai Xie,&nbsp;Pingping Huang,&nbsp;Yudi Jin,&nbsp;Xia Wang,&nbsp;Ying Chen","doi":"10.1016/j.aohep.2025.101790","DOIUrl":"10.1016/j.aohep.2025.101790","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common liver disease affecting people's health, with its incidence increasing year by year. This study aims to determine the effects of Health Action Process Approach (HAPA)-based health management on patients diagnosed with MASLD.</div></div><div><h3>Patients and Methods</h3><div>204 MASLD patients were selected from the hospital's physical examination center from January 1, 2023, through April 1, 2023. Patients are randomly assigned to two groups (<em>n</em> = 102 each) using an envelope-based. Individuals in the experimental group received case management based on the HAPA theory, while standard health management was employed for control group patients. All subjects were monitored over a 6-month period, comparing body mass index (BMI), waist-to-hip ratio (WHR), levels of liver function (AST, ALT), blood lipid levels (total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and health behaviours (as assessed with the HPLP-II health promotion lifestyle scale) before and after the intervention.</div></div><div><h3>Results</h3><div>Post-intervention, the experimental group showed significant improvement in fatty liver (<em>P</em> &lt; 0.01) and reductions in biochemical indices, BMI, and WHR levels (<em>P</em> &lt; 0.05), and a corresponding improvement in HDL-C levels (<em>P</em> &lt; 0.001), compared to the control group. Additionally, patients in the experimental group exhibited significantly better health behaviour scores related to stress management, exercise, diet, and health responsibility compared to controls (<em>P</em> &lt; 0.01).</div></div><div><h3>Conclusions</h3><div>HAPA theory-based case management can improve blood lipid profiles, liver function, and health-related behaviours in MASLD patients, highlighting its potential as an effective management strategy for this condition.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 2","pages":"Article 101790"},"PeriodicalIF":3.7,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143424656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ethnic differences in metabolic and histologic features among White, Hispanic, Black and Asian patients with metabolic-associated Steatotic liver disease: A network meta-analysis","authors":"Limin Lin ,&nbsp;Jiaming Lai ,&nbsp;Ling Luo,&nbsp;Junzhao Ye,&nbsp;Bihui Zhong","doi":"10.1016/j.aohep.2025.101780","DOIUrl":"10.1016/j.aohep.2025.101780","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>Current evidence on the impact of ethnic disparities on metabolic-associated steatotic liver disease (MASLD) is limited to individual studies with small sample sizes from specific regions. This network meta-analysis aimed to assess variations in metabolism and histological characteristics of MASLD among four ethnicities.</div></div><div><h3>Materials and Methods</h3><div>Observational studies on MASLD involving at least two ethnic groups (White, Black, Asian, and Hispanic) were identified from PubMed, Embase, and Web of Science databases up to May 7th, 2024, for inclusion in this study. The results were reported as unstandardized mean differences (MDs) and odds ratios (ORs) with 95% confidence intervals (CIs).</div></div><div><h3>Results</h3><div>A total of twenty-seven articles involving 14,440 non-Hispanic Whites, 4,927 non-Hispanic Blacks, 5,254 Asians, and 8,344 Hispanic MASLD patients were included in this study. The prevalence of type 2 diabetes mellitus of all ethnic groups combined was 33%, without significant difference among the four ethnicities. Asians showed higher levels of total cholesterol compared to the other groups, while Blacks had the lowest levels of alanine aminotransferase. Among biopsy-proven MASLD patients, Blacks individuals had a lower risk of significant fibrosis compared to Whites (OR=0.63, 95% CI: 0.45 to 0.87), as well as lower risks of liver inflammation (OR=0.53, 95% CI: 0.29 to 0.95) and nonalcoholic steatohepatitis (NASH) (OR=0.53, 95% CI: 0.29 to 0.95) compared to Hispanics.</div></div><div><h3>Conclusions</h3><div>Asians MASLD patients had higher risk of suffering from abnormal lipid metabolism while Black MASLD patients presented milder liver histologic features than both Whites and Hispanics individuals.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 2","pages":"Article 101780"},"PeriodicalIF":3.7,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143424652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diastolic dysfunction: Prevalence and outcome in liver transplantation candidates","authors":"Francis Voet ,&nbsp;Maxim Khalenkow ,&nbsp;Michel De Pauw ,&nbsp;Xavier Verhelst ,&nbsp;Sander Lefere ,&nbsp;Anja Geerts ,&nbsp;Hans Van Vlierberghe ,&nbsp;Sarah Raevens","doi":"10.1016/j.aohep.2025.101784","DOIUrl":"10.1016/j.aohep.2025.101784","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>Cirrhotic cardiomyopathy (CCM) is a cardiac complication of cirrhosis primarily presenting as diastolic dysfunction (DD). The original diagnostic criteria from 2005 were updated in 2019. This retrospective study aimed to determine the prevalence and clinical impact of DD in liver transplantation (LT) candidates.</div></div><div><h3>Materials and Methods</h3><div>Data from 233 adult cirrhotic LT candidates were analyzed, and echocardiographic data were used to define DD in all patients using the original criteria and the revised criteria.</div></div><div><h3>Results</h3><div>The prevalence of DD was 72,1 % using the original criteria for DD and 6,4 % using the revised criteria. Patients with DD according to the revised criteria were older than those without DD. Other clinical characteristics were similar between groups. Waitlist mortality was 13,3 % in patients with DD versus 9,2 % in patients without DD (NS), according to the revised criteria. A similar percentage of patients with DD (80 %) underwent LT compared to patients without DD (89 %). Post-LT survival rates were comparable between patients with DD (87,3 % by original criteria, 91,7 % by revised criteria) and patients without DD (81,3 % by original and 85,6 % by revised criteria). Notably, lower e’ lateral values pre-LT were associated with post-LT mortality. Major adverse cardiovascular events post-transplantation occurred in 16,7 % of patients with pre-LT DD and in 13,9 % of patients without pre-LT DD (NS).</div></div><div><h3>Conclusions</h3><div>According to the revised criteria, 6,4 % of LT candidates in this cohort had DD. The presence of DD did not significantly impact overall post-transplant mortality.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 2","pages":"Article 101784"},"PeriodicalIF":3.7,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143413046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment for hepatocellular carcinoma after immunotherapy","authors":"Landon L. Chan,&nbsp;Tsz Tung Kwong,&nbsp;Johnny C.W. Yau,&nbsp;Stephen L. Chan","doi":"10.1016/j.aohep.2025.101781","DOIUrl":"10.1016/j.aohep.2025.101781","url":null,"abstract":"<div><div>Immunotherapy has revolutionized the treatment landscape for advanced HCC, resulting in prolonged response and improved survival. With these results, a pressing question arises: what is the optimal treatment following first-line immunotherapy? Despite the benefits of immunotherapy, most patients will experience disease progression within six months and will require subsequent therapies. International guidelines recommend second-line multi-kinase inhibitors following progression on immunotherapy; however, this recommendation is primarily based on expert consensus rather than high-quality evidence. Nevertheless, real-world data indicate that these agents demonstrate similar efficacy and safety when used as first-line treatments. Conversely, it remains unclear whether continuing immunotherapy after progression is beneficial. In some cases, adding anti-CTLA-4 as salvage therapy has shown effectiveness. Molecular-directed therapies have also been tested, showing some initial promise, but further data is needed to confirm the benefits of this approach. Emerging evidence suggests that patients experiencing oligoprogression may benefit from local or locoregional therapies while continuing immunotherapy. In this review, we will discuss treatment strategies following progression after first-line immunotherapy.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 2","pages":"Article 101781"},"PeriodicalIF":3.7,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143389936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Economic evaluation of non-invasive test pathways for high-risk metabolic dysfunction-associated steatotic liver disease (MASLD) in the United Kingdom (UK)","authors":"Zobair M. Younossi ,&nbsp;James M. Paik ,&nbsp;Linda Henry ,&nbsp;Richard F. Pollock ,&nbsp;Maria Stepanova ,&nbsp;Fatema Nader","doi":"10.1016/j.aohep.2025.101789","DOIUrl":"10.1016/j.aohep.2025.101789","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>Non-invasive tests (NITs) identifying high-risk MASLD in primary care is suggested but, these strategies cost-effectiveness remain uncertain in the United Kingdom (UK).</div></div><div><h3>Materials and Methods</h3><div>A cost-utility/budget impact model was developed for cost-effectiveness evaluation of two screening strategies (1) FIB-4 followed by Enhanced Liver Fibrosis (ELF) (FIB-4/ELF); (2) FIB-4 followed by Transient Elastography (FIB-4/TE) compared to standard of care (SoC). A cohort of primary care MASLD patients with an advanced fibrosis prevalence of 4.20 % was simulated. A decision tree classified patients as true positives, false positives, true negatives, or false negatives based on NIT diagnostic accuracy, followed by a 3-year Markov model to estimate costs and quality-adjusted life years (QALYs). The model included 11 health states: MASLD, fibrosis stages (F0–F3), cirrhosis, decompensated cirrhosis, liver transplant, and death. Costs came from the National Tariff, National Schedule of Costs and Personal Social Services Research Unit.</div></div><div><h3>Results</h3><div>SoC had a false diagnosis rate of 36.26 %, while FIB-4 with ELF or TE reduced false positive rates to 23.20 % and 20.91 %, respectively. Compared to 112,807 unnecessary hepatology referrals under SoC, FIB-4/ELF or FIB-4/TE reduced unnecessary referrals by 38,031 (33.71 %) and 45,767 (40.57 %), respectively. Both strategies demonstrated cost-effectiveness relative to SoC with total cost per patient of GBP 983.37 for FIB-4/TE, GBP 993.15 for FIB-4/ELF compared to SoC, GBP 1,014.15.</div></div><div><h3>Conclusions</h3><div>Sequential NIT screening strategies, combining FIB-4 with ELF or TE, are cost-saving, reduce unnecessary hepatology referrals, and offer an efficient (improve outcomes and reduce healthcare costs) approach for managing high-risk MASLD in UK primary care.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 2","pages":"Article 101789"},"PeriodicalIF":3.7,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143389926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between red blood cell indices and non-alcoholic fatty liver disease: Prospective study and two-sample Mendelian randomization analysis based on large cohorts","authors":"Rui-ning Li ,&nbsp;Qi-mei Li ,&nbsp;Sheng-xing Liang ,&nbsp;Chang Hong ,&nbsp;Rong-feng Zhang ,&nbsp;Jia-ren Wang ,&nbsp;Hong-bo Zhu ,&nbsp;Hao Cui ,&nbsp;Jing-zhe He ,&nbsp;Yan Li ,&nbsp;Xue-jing Zou ,&nbsp;Wen-yuan Li ,&nbsp;Lin Zeng ,&nbsp;Li Liu ,&nbsp;Lu-shan Xiao","doi":"10.1016/j.aohep.2025.101775","DOIUrl":"10.1016/j.aohep.2025.101775","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>Non-alcoholic fatty liver disease (NAFLD) is the primary contributor to persistent chronic liver disease which derives cardiovascular disease, malignancies, and related mortality. There is an association between red blood cell (RBC) indices and the incidence of NAFLD, but the causal relationship has not been determined. We aimed to investigate the association through prospective and Mendelian randomization (MR) analyses.</div></div><div><h3>Materials and Methods</h3><div>The prospective study involved 237,016 participants from the UK Biobank. We employed Cox proportional hazard models and restricted cubic spline models to assess the association between RBC index and NAFLD, and used two-sample MR analysis to identify any causality.</div></div><div><h3>Results</h3><div>Over a mean follow-up of 8.64 years, 2,894 participants from UK Biobank developed NAFLD. The prospective study showed significant associations between high levels of hemoglobin (HGB) (hazard ratio [HR], 1.41; 95 % confidence intervals [CI] 1.24–1.60; <em>P</em> &lt; 0.001), RBC count (HR, 1.20; 95 % CI, 1.07–1.36; <em>P</em> = 0.003) and an increased risk of NAFLD. MR analysis indicated a causal relationship between high HGB levels and NAFLD risk (Odds ratio [OR], 1.55; 95 % CI, 1.11–2.18; <em>P</em> = 0.010). However, there was no observed causal relationship between RBC count and NAFLD.</div></div><div><h3>Conclusions</h3><div>This prospective and MR analysis demonstrated a positive causal relationship between HGB levels and NAFLD. HGB can predict the risk of NAFLD, which can potentially be used as a large-scale non-invasive tool to dynamically monitor the occurrence and development of NAFLD.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 2","pages":"Article 101775"},"PeriodicalIF":3.7,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143073229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}